Dr. Michael Utech, owner of the Institute for Holistic Exercise Therapy in Hanover, explains in an interview the philosophy he follows and what has changed in his clinic with the use of the Innowalk Pro as a therapy device.
An important goal is to enable people to stand upright if they don’t have the strength to do this on their own. The Innowalk Pro, a full-body, motorised movement trainer, helps with this immensely.
We target people who have challenges related to the musculoskeletal system
The institute treats conditions related to the musculoskeletal system, such as a blockage in the sacroiliac joint, torn ligaments or amputations. In addition they have special focus on treating people with severe and multiple impairments, such as cerebral palsy, multiple sclerosis, Parkinson's disease, craniocerebral trauma or stroke. "The reason for this," explains Dr. Utech, "is that we work closely with the residential and care centre and the vocational rehabilitation centre of Annastift in Hanover. People with disabilities live or work there. "We have also collaborated with the vocational training centre of the Annastift. The institute has rented the local exercise pool and uses it for therapeutic purposes.
His concept is based on human evolution, explains Dr. Utech. "Until about 200 years ago, there were no technical power boosters in the form of cars, escalators or elevators. Humans had to move much more throughout a day than they do today, for example to obtain food. If you keep this in mind, then it is clear that the human body has evolved in such a way that it must be active, and if this is not possible, it must be kept active from time to time. Ideally, this should be ensured not only by using safe equipment, but also by free training of various challenges, like walking between bars" explains Dr. Utech. “The movement training should be oriented to everyday life as far as possible and should correspond to the strength and degree of impairment of the patient.”
Therapy oriented towards everyday situations
The orientation towards everyday situations is particularly evident in the facilities of his insitute. The facilities are similar to what you find in a gym, which we all know from our physical education in school. The existing devices, such as wall bars, small boxes, soft floor mats, ropes hanging from the ceiling, etc., can be used in a variety of ways and can therefore also be combined infinitely. “With these individual devices, a whole world of therapy options can be customised for each patient,” explains Dr. Utech.
"For all patients who cannot walk or stand without support, we use the Innowalk Pro. Here, we have excellent options to provide appropriate care for our patients, as it is possible to customise the training in the Innowalk Pro to meet individual abilities and performance possibilities. They can train actively or passively at lower or higher weight loads.”
How long does a therapy session last and what does it cost?
"Typically, one training session with the Innowalk Pro takes about 25 minutes. After consultation, however, the duration of the therapy can be changed. Either a patient has a relevant prescription from his/her doctor or the patient bears the costs privately.
Is the Innowalk Pro cost-effective to clinics as well?
Yes, the Innowalk Pro not only provides excellent therapeutic benefits, but the cost of the device can be recovered fairly quickly with appropriate utilization rate.
Why is the initial consultation so important?
An important part of the therapy at the Institute for Holistic Movement Therapy is the initial consultations. Dr. Utech takes personal care of each patient, and he is always present at the start of the actual therapy.
Dr. Utech told us that he would rather have longer initial consultations than brief ones. The conversation is educating for him as well as the patient. He learns a lot about the patient, and both get to know each other. In addition, it is important to him that his patients also get to know the premises, come there and feel comfortable. In these conversations, priority is always given to what the patient say about themselves.
As often is the case, things that are usually left out in a medical report are discussed in these consultations. The patient can tell about themselves: who they are, what health challenges they have, how are they are feeling at the moment, what problems exist in their private and professional everyday life or what they wish for their future. It is important to know about the patient’s profession, as a major part of the stress on the body can be caused by it. The same applies to hobbies. In addition, if possible, the therapy is designed according to the existing skills and preferences of the patients.
The movement therapy triad
Dr. Utech describes the three building blocks as follows:
- Appropriate movement tasks must be performed that do not pose a risk of injury. The tasks must not be too difficult, but also not too easy, otherwise no training and therapy can be effective.
- Explanation about a particular task is provided before and during that task. Because, only if you understand the meaning and purpose of an exercise would you be interested and motivated to do it.
- The third important component is fun and pleasure in therapy, because only then do the patients like to come here and exercise and are receptive to new inputs.
In Dr. Utech's opinion, these are basic prerequisites for successful and sustainable therapy.
How is the movement trainer Innowalk Pro integrated into this triad?
This triad serves as the basis and requirement for the treatment methods. How and where does the movement trainer Innowalk Pro fit in?
"I have previously addressed the appropriate movement tasks. With the Innowalk Pro, we now have the possibility to mobilise patients in a way that was not possible before," Dr. Utech explains. "For example, we can now work with a patient with quadriplegi in an upright standing position. Previously, we did this using wall bars. This is often challenging - also for the therapist. Especially when the patient is large and heavy with poor balance. For these patients it becomes difficult to predict whether the next step will be correct or if they will trip sideways. You have to stand very close to these patients and support them. This is exhausting for the therapist, and they cannot keep up with this task for very long.”
Endurance training is also possible
Endurance training on wall bars is difficult to perform. That's why we now have the Innowalk Pro. Not only the patients, but also our employees are all very happy with it. There are now more exercise options. In addition, the therapists see that it is fun for the patients. The device is used on a regular basis by those who have been with us for a long time. The patients like to train in the Innowalk Pro so much that if it is unavailable due to maintenance work, they get upset.
With the full-body movement trainer Innowalk Pro, we can plan appropriate exercises for patients who cannot stand independently. There are several possible applications for training. We can practice dynamic movements in a vertical position, and offer all the advantages that standing upright presents. For example, is it beneficial for the cardiovascular system and muscles, and it can reduce digestive problems.
Depending on the core stability of our patients, we can make various adjustments to the movement trainer. In very unstable patients, the pads and straps are tightened and for patients who are more stable, we can loosen the adjustments a bit. So a good core strengthening is also possible to achieve.
In addition, the handles can be removed so that the hands are free, for example to hold a ball. ‘Throwing a ball back and forth, shifting the body's centre of gravity and all this together with the movement of the legs. You certainly can't do that without the Innowalk Pro," Dr. Utech explains.
Innowalk Pro training as an excellent preparation for other therapies
With the Innowalk Pro, as already mentioned, cardiovascular training is also possible, improving endurance. Also the strength of the core and legs improve during this type of training.
Thus, this is a good preparation training for future therapy using for instance a gait trainer with partial weight relief with the help of parachute pants mounted under the ceiling or on the wall bars and therefore enabling freer movement for the patient.
What relief does the Innowalk Pro offer for therapists?
“In the beginning, the device was quite complicated for the employees to operate, but now they are familiar with it,” explains Dr. Utech, “especially since the employees realized that the device relieves most of their work load, and this is a huge advantage for them. This is a huge benefit. In the Innowalk Pro, the patient is safe, so that the therapist can move away a bit and get a better view for posture corrections. This is not possible in free training on the wall bars, as the therapist has to hold the patient with one hand or even stand close behind them.
The Innowalk Pro is therefore also quite suitable for posture training without movement. The patient can simply stand freely. Ideal to develop a sense of physical well-being. Another option is cross-walking with and without arm handles.
The set-up times are now short and the staff does everything fairly quickly."
What is the added value of the Innowalk Pro from the therapists' point of view?
Therapists can focus on other tasks such as posture correction or assist the patients in a different way. In addition, they are significantly relieved of physically strenuous tasks.
This means: The practice is also becoming more attractive for new employees?
“Yes, absolutely. Young and especially newly educated therapists who are interested in working with people with severe disabilities are well informed about innovations and enjoy working with such modern therapy device as the Innowalk Pro. That brings me joy too,” enthuses Dr. Utech.
“Even for a person like me, who prefers using 'simple' devices, see it as very useful to apply high-tech devices and aids that are state-of-the-art for specific physical requirements of the patient. Otherwise I wouldn't have installed Innowalk Pro in my institute.”
Getting patients to stand and motivating them, fulfils all my wishes.
From the very beginning, my goal was to help primarily wheelchair-bound patients to stand upright.
"It was immediately clear to me that the Innowalk Pro delivers exactly as per my goal: Help patients to stand upright, who cannot do it themselves. As mention in the beginning: It also takes evolution into account and that the body is actually built for movement and what problems arise if movement is not possible. We care for many patients who are permanently wheelchair-bound and complain of back pain, contractures in the hip joint area or digestive problems. If I can make these patients stand upright and move at the same time, this fulfils all my wishes. Patients feel that they can improve their independence and have better opportunities to participate in social life. The therapy and its body-related benefits are ultimately the way to achieve the actual goal of every therapeutic measure: The increase in well-being, which is characterised by physical abilities, self-image and social interaction.
A special aspect of the Innowalk Pro is also that the patients can interact with others at eye-level. They are slightly elevated and can view from top to bottom – they have the overview – and do not sit and look at things from bottom up. This adds a new, great perspective, which should not be underestimated.
How does the Innowalk Pro investment pay for the institute?
For Dr. Utech the Innowalk Pro brings added value in two ways.
On the one hand, monetarily via a reimbursement by doctor's prescription, or through private patients who pay by themselves as well as through patients who come to him as a result of close cooperation with the employers' liability insurance associations. Here he has the possibility to set a cost rate that better corresponds to the high utility value of the device.
On the other hand, there is the intangible added value. Ultimately, it is a statement for him and the institute: "What do we stand for? Which patients do we cater for? We have a reputation as a centre of excellence for people with severe disabilities and as an inclusive rehabilitation facility,” Dr. Utech concludes our interview.